RT Journal Article
SR Electronic
T1 Improved walking speed is associated with lower hospitalisation rates in patients in an exercise-based secondary prevention programme
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP 1902
OP 1908
DO 10.1136/heartjnl-2015-309126
VO 102
IS 23
A1 Giovanni Grazzi
A1 Gianni Mazzoni
A1 Jonathan Myers
A1 Luciano Codecà
A1 Giovanni Pasanisi
A1 Nicola Napoli
A1 Franco Guerzoni
A1 Stefano Volpato
A1 Francesco Conconi
A1 Giorgio Chiaranda
YR 2016
UL http://heart.bmj.com/content/102/23/1902.abstract
AB Objective To determine the relationship between walking speed (WS) maintained during a 1 km test and its improvement on hospitalisation in cardiac outpatients who were referred to an exercise-based secondary prevention programme.Methods Hospitalisation was assessed in 1791 patients 3 years after enrolment and related to the WS achieved during a 1 km walk at moderate intensity on a treadmill. Hospitalisation was also assessed during the fourth-to-sixth years as function of improvement in WS in 1111 participants who were re-evaluated 3 years after baseline.Results Three-year hospitalisation rate across tertiles of baseline WS was 50% for the slow walkers (2.7±0.6 km/hour), 41% for the moderate (4.1±0.3 km/hour) and 25% for the fast walkers (5.2±0.5 km/hour) (p for trend <0.0001), with adjusted HRs (95% CI) of 0.93 (0.74 to 1.17, p=0.53) for intermediate and 0.58 (0.43 to 0.78, p=0.0003) for fast. Every 1 km/hour increase in WS was associated with a 21% reduction in hospitalisation (p<0.0001). Hospitalisation from the fourth-to-sixth years was lower across tertiles of improved WS, with 44% for the low (0.2±0.4 km/hour), 34% for the intermediate (0.8±0.2 km/hour) and 30% for the high tertile (1.6±0.4 km/hour) (p for trend <0.0001). Adjusted HRs were 0.68 (p=0.002) for the intermediate and 0.58 (p<0.0001) for the high tertile. Every 1 km/hour increase in WS was associated with a 35% reduction in hospitalisation (p<0.0001).Conclusion Improvement in WS is associated with a significant, dose-dependent lower rate of all-cause hospitalisation in cardiac outpatients. WS is a simple, easily applied and clinically useful tool for cardiac patients undergoing secondary prevention.